探討老人帶有身心障礙之照顧與健康管理

Discussion of the Care Management of Elderly with Disability

李宗派(Isaiah C. Lee)

《臺灣老人保健學刊》 8卷1期 (2012/06) Pp. 1-19

https://doi.org/10.29797/TJGHR.201206.0001

摘要

這篇文章目的在探討老人帶有身心障礙之照顧服務與健康管理。文章先介紹美國老年人口之概觀與特徵以及世界人口帶有身心障礙之概觀與統計要點。文章內容第一段則說明身心障礙與失能之基本概念，包括了身體的、認知的、精神的、感官的、心理情緒的、發展的，以及一些混合的概念。身心障礙係為一種複雜的身心器官與生活功能（ADLs & IADLs）以及社會互動所表現之綜合現象。第二段說明老人染患身心障礙之照顧課題與生活服務，包括了經濟安全收入之保障、醫療保健服務之提供、居家護理與日間照顧、老人休閒與教育服務、老人陪伴與交通服務、老人保護與法律諮詢、建立全國性之身心障礙資料管理制度，以及經常舉辦老人之身心障礙研討會提供最新之服務訊息與老人政策給予老人相關之人士與政府參考。第三段說明老人染患身心障礙之健康管理，界定障礙與失能之專業用詞。強調預防、治療，與復健之管理課題與重要性，並建議老人養護機構之管理者要熟讀經典之管理原則，即飛約十四管理原則：分工、權威與責任、紀律、命令之一致性、指揮之一致性、放下個人之利益、適當報酬、中央集權與分權、權威行列、秩序、公平、人事職位之穩定性、主動性，與團隊精神。結論則強調老人之身心障礙照顧與服務必須重視照顧服務人才之培育訓練，要有先見創新之健康管理領導人才，要有人性與科學之機構管理制度。身心障礙者之醫療保健與生活服務應該是全面性與持續性的。對於老人之自尊、自重、獨立自主以及生命尊嚴必須加以尊重。

關鍵字

老人 ； 身心障礙 ； 健康管理

並列摘要

The purpose of this paper is to discuss the issues of care management of elderly people with disability. The first section describes the current characteristics of elderly people in United States and in the World. The second section presents the world facts and statistics on disability issues. Currently around 10% of the total world's population, or roughly 650 million people, live with a disability. An estimated 386 million of the working age people have some kind of disability (International Labor Organization). There are around 36 million people or 12% of total population having disability conditions in the United States. Except the number of people institutionalized, there are 5% children and youth; 10% of the adult aged 18 to 64; and 37% of the aged 65 and over having disability conditions living in the community. The third section defines the concept of disability. Disability is an umbrella term, covering impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations. (WHO-2012) The disability may be divided as Physical Disability, Sensory Disability -Visual, -Hearing, Olfactory-Gustatory, Somato-Sensory, and Balance Disorder, Intellectual Disability, Mental Health and Emotional Disabilities or Psychiatric or Psycho-social Disability, as well as Developmental Disability (Mental Retardation). The fourth section discusses the care of elderly with disability conditions. There are Macro and Micro care issues and problems including the economic income security, the provision of medical care services, the home-care and day care, the leisure and education programs for elderly, the elderly companionship and transportation services, the elderly protection and legal aid, the establishment of data management system for elderly care, organizing professional and community conference of elderly care related to disability issues. The fifth section discusses the health management of elderly with disability. The professional staff needs to equip the knowledge and skills of elderly care, the knowledge of aging process in human development, communication skills, handling ethical dilemmas, strategic planning skills, program evaluation methods, budgeting skills for elderly care agency, and volunteer training and management. The Fayal's 14 Principles of Management are recommended for professional managers to study. The conclusion emphasizes that the elderly care professionals should receive further training in health management in order to assess the health issues related to disability, to plan and implement, to coordinate and monitor, and finally to evaluate the effectiveness of elderly care programs in a complex health organization.

並列關鍵字

Elderly ； disability ； elderly with disability ； care management